Document Detail


Antiretroviral use during pregnancy for treatment or prophylaxis.
MedLine Citation:
PMID:  21534886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Antiretrovirals are recommended for all pregnant women either for treatment of HIV-1 infection or for prevention of mother-to-child transmission. Distinguishing between HIV-1-infected pregnant women who meet treatment criteria and those who do not (who use antiretrovirals during pregnancy for prophylaxis) is accomplished by assessing the HIV-1 disease stage and has important implications regarding when antiretroviral drugs are initiated during pregnancy, what drugs are used and antiretroviral use after delivery.
AREAS COVERED: This review addresses antiretroviral use by HIV-1-infected women during pregnancy. Specifically, the review focuses on antiretroviral therapy for HIV-1-infected pregnant women who meet criteria for treatment and antiretroviral prophylaxis for HIV-1-infected pregnant women (to prevent mother-to-child transmission of HIV-1). The review primarily addresses antiretroviral use in resource-rich settings, but use in resource-poor settings is briefly addressed.
EXPERT OPINION: Antiretrovirals represent only one component of the overall management of HIV-1 infected pregnant women and, therefore, cannot be viewed in isolation from other components of optimal care for HIV-1-infected women and from other efficacious interventions to prevent mother-to-child transmission of HIV-1. Antiretrovirals can be used safely and effectively during pregnancy. We concur with current guidelines regarding the threshold that differentiates which women need antiretroviral therapy for HIV-1 infection for their own health versus those who need prophylaxis to prevent transmission of HIV-1 infection to their child. We thus recommend that lifelong antiretroviral therapy be initiated in patients with an AIDS-defining illness, a CD4 count < 350 cells/mm(3) or other co-morbid conditions such as acute opportunistic infections, HIV-1-associated nephropathy or hepatitis B co-infection. Irrespective of whether or not antiretrovirals are used during pregnancy, or whether antiretrovirals during pregnancy are used for treatment or prophylaxis, all infants of HIV-1-infected women should receive antiretroviral post-exposure prophylaxis.
Authors:
Amy S Sturt; Jennifer S Read
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-05-03
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  12     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-18     Completed Date:  2011-11-28     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1875-85     Citation Subset:  IM    
Affiliation:
Medicine/Infectious Diseases, Santa Clara Valley Medical Center, Ira Greene PACE Clinic, 751 S. Bascom Avenue, San Jose, CA 95128 , USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Anti-HIV Agents / adverse effects,  therapeutic use
Anti-Retroviral Agents / adverse effects,  therapeutic use*
Drug Monitoring
Female
HIV Infections / drug therapy*,  therapy,  transmission*
HIV-1*
Humans
Infant, Newborn
Infant, Newborn, Diseases / prevention & control
Infectious Disease Transmission, Vertical / prevention & control*
Male
Medication Adherence
Post-Exposure Prophylaxis
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications, Infectious / drug therapy*,  therapy
Young Adult
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Anti-Retroviral Agents

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